CMS presses for
bundling patient payments REVENUE CYCLE MANAGEMENT
In the current Medicare scenario, hospitals, physicians and other clinicians bill and are paid separately for their services. But that may change soon.
The U.S. Department of Health and Human Services (HHS) announced at the end of August that doctors, hos- pitals and other healthcare providers can now apply to par- ticipate in a program called the Bundled Payments for Care Improvement initiative (Bundled Payments initiative). The Centers for Medicare & Medicaid Services (CMS) program seeks to align payments for services delivered across an episode of care, such as heart bypass or hip replacement, rather than paying for services separately. Bundled pay- ments aim to give doctors and hospitals new incentives to coordinate care, improve the quality of care and save money for Medicare. The Bundled Payments initiative is being launched by the new Center for Medicare and Medicaid Innovation, which was created by the Affordable Care Act. The program is based on research and previous demonstration projects that suggest the approach has lucrative potential. For example, a Medicare heart bypass surgery bundled payment demonstra- tion saved the program $42.3 million, or roughly 10 percent of expected costs, and saved patients $7.9 million in coinsur- ance while improving care and lowering mortality. “This Bundled Payment initiative responds to calls from the hospital and physician communities for a fl exible ap- proach to patient care improvement,” says Donald Berwick, M.D., CMS administrator. “All around the country, many of the leading healthcare institutions have already implemented these kinds of projects and seen positive results.” The Center for Medicare and Medicaid Innovation’s re- quest for applications (RFA) outlines four broad approaches to bundled payments. Providers will have the choice to determine which episodes of care and which services will be bundled together. “From a patient perspective, bundled payments make sense,” says Dr. Berwick. “You want your doctors to col- laborate more closely with your physical therapist, your pharmacist and your family caregivers. But that sort of common-sense practice is hard to achieve without a payment system that supports coordination over fragmentation and fosters the kinds of relationships we expect our healthcare providers to have.” Find out more about the Bundled Payments initiative at www.innovations.cms.gov.
The 83rd Annual AHIMA Convention & Exhibit, Oct. 1-6, Salt Lake City, will draw professionals from all areas of health informatics and information management for a week-long focus on HIM’s global transformation. Learn how to implement some of the most important changes in HIM history. www.ahima.org
Partners HealthCare’s Connected Health Symposium, Oct. 20-21, Boston, will center around the theme of “Driving quality up and costs down: New technologies for an era of accountability.” Network with 1,200 health technology leaders, including hospital execs, community-based doctors, health plan leaders, large employers, government policymakers and leading investors. www.connected-health.org
Medical Group Management Association (MGMA) Annual Conference, Oct. 23-26, Las Vegas, offers more than 100 education and networking sessions and access to more than 350 leading industry exhibitors. Hot topics include: healthcare reform, government incentive programs, health IT adoption, succeeding within integrated care models and streamlining practice operations. www.mgma.com/mgma11
November The 7th Annual World Healthcare Innovation and
Technology Congress, Nov. 7-8, Vienna, Va., combines payer and provider educational programming with a broad range of networking opportunities. Meet more than 400 hospital, health system, medical center, physician practice and health insurance IT decision makers. www.worldcongress.com
RSNA 2011 – The 97th Scientifi c Assembly & Annual Meeting of the Radiological Society of North America, Nov. 27-Dec. 2, Chicago, is the premier scientifi c and educational forum in radiology. Come learn about the latest trends in radiologic research and “celebrate the image” along with 60,000 attendees. http://rsna2011.rsna.org
www.healthmgttech.com HEALTH MANAGEMENT TECHNOLOGY October 2011 7